Financing healthcare : an investigation of the role of medical insurance underwriters

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Health care in Kenya is financed through the government, development partners, and the private sector including non-government organizations, self-help and community contributions. [Kenya Health Policy Framework (KHPF) 1994; Kenya National Health accounts (KNHA) 2003; Ministry of Health (MOH) 1999; Household Health Expenditure and Utilizations Survey Report (HHEUSR) 2003]. Health care in Kenya is under funded since the government finances 60% of what is required to provide minimum health services (Kimalu et al 2004). This is made worse by the inherent inefficiency of the system and lack of cost-effectiveness. The Ministry of Health which runs all public health facilities is unable to cope with the medical care demand partly due to increase in population among other factors. As a result the financial contributions of households have exceeded those of the government. Other sources of funds also experience limitations. For example, NHIF has limited coverage while private sources are regressive due to their demand for out of pocket payments. This Research examines the role of health insurance companies in trying to bridge the financial gap in the health sector. It will be carried out among insurance companies offering Health Insurance in Nairobi province which is the capital city of Kenya and home to people of different economic classes. Literature was reviewed from books, data from health records from the government, magazines, journals, internet and research work conducted earlier by other people. Primary data was collected using questionnaires with both closed and open ended questions. The researcher adopted both exploratory and descriptive research design. All the insurance companies offering Health Insurance will form the sample for this study. . The data was analyzed using descriptive statistics and with the aid of SPSS and presented in tables tabulations, graphs and charts. The study found out that health insurance is still beyond reach of many Kenyans as the premiums have been rising since 2003 making the schemes only affordable to the middle and upper bracket income earners. The study recommends that measures be put in place to encourage the lower income earners to take up the schemes.